James O. Kahn, MD is an Associate Professor of Medicine at the University of California, San Francisco (UCSF), Associate Director of the Positive Health Program (PHP) (formally known as the AIDS Program) at San Francisco General Hospital (SFGH) and Associate Director of the UCSF-Gladstone Institute of Virology and Immunology's Center for AIDS Research (CFAR). Additionally, Dr. Kahn is the former chair of the Committee for Human Research at UCSF. He has completed fellowship training in medical oncology and clinical epidemiology, with an emphasis on research methods. With support from a 3-year Career Development Award from the American Cancer Society, Dr. Kahn attained the experience and skills necessary to become an independent investigator and to build a multidisciplinary research team in patient-oriented research. Dr. Kahn has developed an international reputation as a clinical trialist in patient-oriented HIV/AIDS research, with expertise in the areas of antiretroviral drug development, HIV-1 vaccine development, primary HIV-1 infection and prevention of HIV infection. Dr. Kahn has also been a very active mentor for beginning clinical investigators from diverse backgrounds, including younger physicians on faculty in the PHP, as well as visiting fellows from other countries. All junior faculty supported and mentored by Dr. Kahn are active in patient-oriented research. K-24 support will enable Dr. Kahn to achieve his long-term career goal of establishing a clinical research program that will: (1) integrate a multidisciplinary approach to prevention of HIV-1 infection; (2) conduct exploratory clinical research on the determinants of HIV-1 transmission; (3) include a comprehensive mentoring program for HIV/AIDS clinical investigators; and (4) create a clinical outcomes research agenda that focuses on the clinical effectiveness of HIV care in primary care settings. An initial research focus will be an assessment of the impact of current clinical practice guidelines on the primary medical care of HIV- infected adults, and the long-term virologic, immunologic and clinical outcomes in this population. Data for this prospective, observational cohort will be collected with the use of HIVWatch, a web-based, electronic medical record system developed by Dr. Kahn that contains data on patients who receive their medical care at the Positive Health Practice at SFGH. Dr. Kahn's research program has the enthusiastic support of his deuartment. the leadership of the AIDS Research Institute at UCSF and other nationally recognized clinical researchers.